Under the Knife: MLB Injury Analysis on Kershaw, Wainwright, Sale and More

More injuries? Yes, that's been the storyline across baseball seemingly since camps opened in February. With all of the injuries to big names costing teams time and money, perhaps we should worry about some sort of surgery count for Drs. Andrews, Kremchek and ElAttrache. The scalpel has to be getting dull at this point, but more names are piling up on the DL, like Chris Sale, Ivan Nova, and Carlos Gonzalez.

Monitoring these injuries is tough. I keep an extensive database, and there are others out there, too, but does it surprise you that MLB really doesn't any type of database to the public? They do have an extensive database behind the scenes, including the day-to-day marks that could put research into hyperdrive, but there's less of a chance of this being public than them opening up the feed to FieldF/X.

HIPAA aside, baseball's aversion to research is problematic. The NFL was forced to put $10 million into concussion research. But prior to that? Nothing. Baseball has done well to push for many advancements, but the failure here is dismal.

I'd suggest that one of MLB's biggest successes, the RBI Program, be cloned for sports medicine research. Big grants to places that can make a difference such as equipment manufacturers and medical research hospitals would be nice, but let's go a step further by getting SABR involved and setting up a prize for the best research projects. The league should make more data available to the Sloan types out there and see what happens.

It can't be worse than what it is. If MLB isn't going to try something new on the field to prevent injuries, maybe it can do something new off the field. Until then, we have plenty of injuries to look at around the league this week.

Charles Rex Arbogast

Chris Sale

The news has been positive on Chris Sale—or as positive as it can be when an ace pitcher is headed to the DL. Sale told Dan Hayes of CSN Chicago that the ligament is pristine and that he'll start throwing again shortly. The couple of days off indicates to me that he had PRP or perhaps a more old school cortisone injection.

The Sox are big into preventative maintenance. So while Sale wants to get back to throwing quickly, it wouldn't surprise me to see him spend some extra time on maintenance while being watched closely by Herm Schneider and Don Cooper before the Sox get him back on a mound. For more details on Sale, click here.

Alex Brandon

Craig Kimbrel

Craig Kimbrel is dealing with a sore shoulder, but at the same time he's not showing too many effects from it.

He did have a bad outing on Monday and was held out of a game on Tuesday—though with Braves losing 1-0 it's unclear if the role-locked Kimbrel would have been used anyway. Kimbrel appears to be more a victim of bad luck and bad timing more than a real bad shoulder.

While the soreness is real, a BABIP of .500 is not going to sustain itself. Expect Kimbrel to even things out, especially if Fredi Gonzalez gets him a bit of extra rest over the next week. For more on Kimbrel, click here.

Clayton Kershaw is ready for a rehab assignment. After letting his strained shoulder heal up, he's progressed through a throwing program.

A simulated game on Sunday went well, according to Anthony Witrado of ESPN Los Angeles, as Kershaw displayed good stuff and good results as well as no unusual soreness. The Dodgers haven't set up the date for his rehab start yet, but that will provide our first real clue about when they'll slot him back into the big league rotation.

Regardless, this is a huge plus for the Dodgers. Getting Kershaw back is a boost, but keeping him back and healthy is much more important. For more details on Kershaw, click here.

Kathy Willens

Ivan Nova

Depending on how you count up the scars, Nova could be the 15th MLB pitcher to head for Tommy John surgery. His mid-90s stuff has always tasked his arm, putting him on the DL in each of the last two years and holding his innings totals under 170 despite a solid hold on a rotation spot.

There was no real warning, but a partial tear of the UCL is enough to make the Yankees think they'll need another starter for the next 10-12 months. For more details on Nova, click here.

David Zalubowski

Carlos Gonzalez

Carlos Gonzalez has immense talent, but he has to stay on the field in order to help the Rockies get out of the cellar. Knee tendinitis isn't a good thing, but he has been playing through it for a while. If the Rockies can figure out a way to keep him functional and keep the issue from becoming more severe, Gonzalez should be fine.

Thus far, there's no sign that it's hurting his range in the field or his speed on the bases. If the Rockies medical staff can get Gonzalez and Troy Tulowitzki through a more or less full season together, they shouldn't be looking up at the rest of the division again. For more info on Gonzalez, click here.

Alex Brandon

Adam Wainwright

Wainwright left Tuesday night's start with just 79 pitches thrown and a shutout in place, which would have been his second shutout in a row. He left the game instead, raising speculation that there was a problem.

The Cards medical staff will work hard to minimize things and get Wainwright back as quickly as possible. Depending on his response, there's a lot of variance. A team source tells me that he thinks Wainwright will avoid the DL, but that the team is going to prepare as though his rotation slot could be skipped if necessary. Watch to see if Wainwright is able to make his throw day this weekend for an early sign.

Derrick Goold of the St. LouisPost-Dispatch reported later on Tuesday night that Wainwright is not favoring the knee and expects to go in his next start. If nothing else, the injury gave us one of the best quotes of the year: "My ACL, MCL, UCL, all those LCLs, QCLs, all the CLs are good."

What's behind this year's increase in Tommy John surgeries?

What's behind this year's increase in Tommy John surgeries?

Overuse

29.9%

Random Chance

22.6%

Poor Mechanics

21.6%

Babying Pitchers

25.9%

Total votes: 552

Tommy John is Blind

Not Tommy himself, who's doing well and still involved in baseball, but the surgery and the injuries really don't appear to have any patterns. Rob Neyer of Fox Sports suggested that there was a lower number of Latin pitchers having Tommy John surgery this year.

I've heard this one before, largely focused on how Latin pitchers don't get exposed to high pitch counts the way American players do in their youth. Baseball America's Ben Badler's recent piece on how young Latin players are being scouted should put that myth to bed.

I asked B/R's Tyler Brooke to take a look back at the Tommy John list he put together for last year's series on the surgery. Since it was a solid datapoint, I asked him to look at the breakdown there. Of the 124 pitchers on that list, 34 were Latin American, which accounted for 28 percent. That's about where we'd expect it to be given that 24 percent of pitchers that were Latin.

What Neyer is seeing is randomness at work, I believe. Sadly, there's no easy answer to preventing elbow injuries, but it's sad that Fox Sports is asking better questions about it than MLB itself.

This was as classic a rolled ankle as you're going to see. Choo will have a couple days to caulk the kitchen or do whatever he needs to do as they get the swelling out and the function back, but the Rangers got a bit lucky here with Jim Adducci down. An extended absence could have really made the team thin in the outfield.

Matt Harrison

Harrison had a tough rehab, not because he had problems, because of the weather. I mean, the guy got tornadoed out of his opening start. Since then, Harrison has had trouble with rain but not with his back or arm.

He could be back as soon as Friday, which would be a big boost to the Rangers rotation. They need innings, but Harrison could give them more than that, though don't expect him to be an ace right out of the gate.

Gene J. Puskar

Manny Machado

The Orioles have been conservative with Manny Machado, but after a few games in extended spring training, there's not much more the O's can do to hold their young star back. He's yet to play in the field, but he's looked fine at bat and when running in those complex games.

He'll be in the field on Wednesday and if that goes well, he'll start a rehab assignment over the weekend, per Greg Swatek of the Frederick News-Post. That will come at Frederick, a conservative start. Machado has to be up 20 days after the rehab starts, but it would surprise me if it went much past 40 or 50 at-bats. This is your last chance to steal Machado from someone.

Cole Hamels

Hamels will come off the DL on Wednesday. There's no reason to think that he won't go back to his normal stuff, but watch in his first few starts whether his stamina is normal.

I don't have a great feel for how Ryne Sandberg will handle starters, especially ones coming back from injury. But I'd expect him to be a bit cautious, which could cause Hamels to come out a bit earlier than normal, costing some win opportunities. It will be a very short term watch, however. I'd get Hamels in, no matter the format.

David Robertson

Shawn Kelley has been a nice fill in, but David Robertson was activated from the DL on Tuesday. He'll go right back to his closer role, though he wasn't needed that night given a dominant performance from Masahiro Tanaka and a big lead.

Robertson shouldn't have any trouble from his injured groin given the time and treatment. The Yankees medical staff will have checked him thoroughly, so it's unlikely Joe Girardi will ease him back into the role.

Casey Janssen

The Jays have had a tough time keeping anyone healthy, but Janssen's not just anyone. He's injury prone and a high effort guy, so any sort of setback with his back problem should really be baked in at this point.

With Sergio Santos healthy, for now, the Jays have cover, but any more setbacks could really expose the back of the Jays pen.

Rogelio V. Solis

Those mechanics look perfectly normal, right?

Mike Minor

The Braves have enough injury issues happening that any good news has to sound like Christmas morning. Instead, they're returning their gift. Mike Minor was set to start for the Braves on Saturday, but instead he'll go to Mississippi for a start on Friday.

It's not clear what more they're looking for from Minor after four rehab starts with solid results and building stamina, but that's the decision. Minor will have to come off the rehab assignment before another could be made, so he's expected to be back in the Atlanta rotation later next week absent a major setback.

Cameron Maybin

Remember what I said about Maybin's shoulder injury showing up while he is at bat even more than when he is throwing? That's what scouts have been telling me during his rehab assignment as well.

He's batting under .200 and "looking bad doing it," said one observer who saw him playing for the El Paso Chihuahuas. The shoulder is not near full strength, and Maybin is still adjusting to it at the plate. The Padres don't seem bothered and could call him up soon despite the issue. I'd stay away from him or at least keep him on the bench until he shows that he can make consistent contact.

Morry Gash

Aroldis Chapman

Aroldis Chapman continues to make big strides in returning to the Reds bullpen after his scary spring injury. The staples are out and his face is fine now, so they're working on the arm. He's done well at every step, but will progress to live hitters on Wednesday.

If that goes well, he could head out on a very short rehab stint. The Reds want to see him pitch in a live setting and in back-to-back settings. A source tells me he's shown no hint of "flinch" while throwing, which they were worried about, though they'll be watching this closely in live action.

He's done well with PFP, and I'm told they tested him there. While Jonathan Broxton's return gives them some leeway, expect Chapman back on or before May 1.

Mat Latos

The Reds get a bit more good news. Mat Latos has had an injury-plagued spring, but things are looking up. After a pair of surgeries and a minor setback just before a rehab start, Latos is going to start his throwing program back up this week.

He could make a rehab start by next week, and depending on his stamina, that could be a pretty short rehab stint. The Reds would like to get him back in the rotation, looking for anything behind Johnny Cueto, their only solid starter so far.

Scott Feldman

The Astros pushed their No. 1 starter to the DL. Scott Feldman was diagnosed with biceps tendinitis, but after the recent death of his father, some sources I've talked to have speculated that this is a compassionate way to get him a break, both physically and mentally.

If so, kudos to the Astros. Feldman shouldn't be out more than the minimum, according to my sources, but I think we'd all understand if he was.

Josh Johnson

It's not official yet, but Josh Johnson is likely to add to the total of Tommy John surgeries done this season. Johnson went from Toronto to San Diego in hopes of staying healthy, but that's a sports medicine version of out of the frying pan and into the fire. Neither organization has done well keeping pitchers healthy over the last decade. J

Johnson will get another shot next year, somewhere. If he and his agent are smart, they should consider the White Sox, Rays or Brewers first.

Elaine Thompson

Mariners Pitchers

It's never good to have to go with a group of anything when it comes to injuries. The Mariners have been making their way through April without their entire middle of the rotation. It's Felix Hernandez and a cast of extras, basically, but things are looking up.

Hisashi Iwakuma is going to start a rehab assignment, while James Paxton is ready to start throwing again. Taijuan Walker is a bit tougher to read due to his setback, but getting him back out and throwing is also a positive. If the Mariners can tread water and get the rotation upgraded as they get healthy, this team will take another step up.

Dylan Bundy

Bundy is mixing in breaking balls in his throwing sessions now. He's not far from throwing to batters, which would be followed by a rehab assignment. The goal is to have him ready to go in July, but where he'll be pitching is unclear. Expect the Orioles to treat him like the Yankees did with Michael Pineda last season.

Delino DeShields Jr.

I don't normally cover minor leaguers, but this story deserves your attention. Delino DeShields Jr. took a 90 mph fastball to the face and, if you're not squeamish, click through to Jimmy Traina's interview with him to see the pictures. Traina does a nice job getting DeShields to talk about the incident. Thankfully, DeShields is OK, and, fortunately, this is an uncommon occurrence.